Molloy D William, Standish Timothy I, Dubois Sacha, Cunje Alwin
St. Peter's Centre for Studies in Aging, St. Peter's Hospital, Hamilton, Ontario, Canada.
Int Psychogeriatr. 2006 Sep;18(3):481-92. doi: 10.1017/S1041610205003078. Epub 2006 Apr 26.
Depression is common in elderly people but physicians may not screen for it because of the length of time required by current screening instruments. We have developed a short screening instrument for depression for use in elderly people with normal cognition, mild cognitive impairment or early dementia.
Participants were aged 55 years or more, had scored 20 or more on the standardized Mini-mental State Examination (SMMSE) and had been referred to a specialist geriatric outpatient memory clinic. Scores on the 30-item Geriatric Depression Scale (GDS) were analyzed. A composite GDS score, consisting of the top five individual question scores that correlated to depression (GDS >or= 14), were analyzed using a receiver operating curve analysis.
There were 810 patients with SMMSE scores of 20 or greater, of whom 202 (24.9%) scored 14 or more on the GDS, indicating depression. GDS question 16, "Do you often feel downhearted and blue?," had the highest correlation with the overall scores of 14 or more on the 30-point instrument (r = 0.64, p < 0.001). The next four questions with the highest correlates were Q10, "Do you often feel helpless?" (r = 0.56, p < 0.001), Q3, "Do you feel that your life is empty?" (r = 0.54, p < 0.001), Q9, "Do you feel happy most of the time?" (r = 0.52, p < 0.001), and Q1, "Are you basically satisfied with your life?" (r = 0.50, p < 0.001). The negative predictive value of "Do you often feel downhearted and blue?" answered negatively for depression was 96%. These five questions were used as a short screening instrument. The positive predictive value of four or five positive responses was 97%. These data were not significantly different whether the patient's SMMSE score was 20-25 or 26-30.
The AB Clinician Depression Screen (ABCDS), comprising five questions, can rapidly identify patients with depression or eliminate that diagnosis. In this population, these five questions may be used instead of the longer 30-question GDS scale.
抑郁症在老年人中很常见，但由于目前的筛查工具耗时较长，医生可能不会对其进行筛查。我们开发了一种简短的抑郁症筛查工具，用于认知正常、轻度认知障碍或早期痴呆的老年人。
参与者年龄在55岁及以上，在标准化简易精神状态检查表（SMMSE）中得分20分及以上，并已被转诊至老年专科门诊记忆诊所。分析了30项老年抑郁量表（GDS）的得分。使用受试者工作特征曲线分析对由与抑郁症相关的前五个单项问题得分组成的综合GDS得分（GDS≥14）进行分析。
有810名SMMSE得分20分及以上的患者，其中202名（24.9%）在GDS上得分14分及以上，表明患有抑郁症。GDS问题16“你是否经常感到沮丧和忧郁？”与30分量表上14分及以上的总分相关性最高（r = 0.64，p < 0.001）。接下来相关性最高的四个问题是Q10“你是否经常感到无助？”（r = 0.56，p < 0.001）、Q3“你是否觉得你的生活很空虚？”（r = 0.54，p < 0.001）、Q9“你大部分时间都感到快乐吗？”（r = 0.52，p < 0.001）和Q1“你对你的生活基本满意吗？”（r = 0.50，p < 0.001）。对“你是否经常感到沮丧和忧郁？”回答为否对抑郁症的阴性预测值为96%。这五个问题被用作简短的筛查工具。四个或五个阳性回答的阳性预测值为97%。无论患者的SMMSE得分是20 - 25还是26 - 30，这些数据均无显著差异。
由五个问题组成的AB临床医生抑郁筛查表（ABCDS）可以快速识别抑郁症患者或排除该诊断。在这一人群中，这五个问题可用于替代更长的30个问题的GDS量表。
